This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Monday, September 09, 2013

Weekly Australian Health IT Links – 9th September, 2013.

Here are a few I have come across the last week or so.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

With the election done and dusted we now need to see what happens next. We have to assume there will be a period of consolidation and probably it will be towards the end of the year before we see any changes. I guess we can just standby for a while!

For this week there is little else to say…I think things will be very quiet for a while.

The Consumers e-Health Alliance says the incoming government needs to address the troubled national medical information-sharing system with some urgency if any benefits are to accrue from efforts to date.

“The primary aim of any e-health system must be to improve outcomes of individual patients who choose to participate, and to also address population health improvements,” CeHA convenor Peter Brown said.

“But the Personally Controlled e-Health Record program is not yet achieving that goal, nor is it delivering the broader community and productivity benefits needed to sustain a quality healthcare service.

This scorecard shows progress in adoption of national eHealth programs across sectors. Uptake is shown for the PCEHR system, secure messaging, electronic prescriptions and dispense ratios, healthcare identifiers and the national authentication service for health. This scorecard does not present a complete picture of uptake of eHealth, as it is limited by the data available to NEHTA.

Pharmacists working outside “lead e-health sites” are being encouraged not to sign the National e-Health Transition Authority (NeHTA) participation agreement, which is a requirement for the PCEHR.

The latest NeHTA scorecard for organisation uptake of e-health, including the PCEHR, found that readiness for the system was moderate in the community pharmacy sector, with software that implements NeHTA specifications available to 65% of the market.

However, just 271 community pharmacies were registered with the PCEHR on 10 July 2013, up from 168 in the previous reporting period.

“This represents an increase of just over 60%, but from a low base” the report said.

“The majority of pharmacies registered in the PCEHR system are in Tasmania, Queensland and Victoria, with Tasmania having registered an estimated 48 per cent of all pharmacies in the state.

HEALTH Minister Tanya Plibersek has warned that the Coalition’s intended review of Medicare Locals is little more than a “veiled” excuse to dismantle the primary healthcare bodies and sack thousands of frontline staff.

In an exclusive interview with MO ahead of the 7 September election, Ms Plibersek defended Labor’s controversial GP super clinics, saying it “drives me crazy” that the $600 million-plus program was branded a disaster when millions of Australians had benefited from it.

Ms Plibersek, who became health minister in December 2011, continued Labor’s strategy of attacking Coalition policies, saying that although promises like extra grants for general practice had been welcomed by doctors, they were no different to Labor policies already in place.

She said she feared that the ML review, announced by shadow health minister Peter Dutton after he complained of 3000 unneeded bureaucrats in the ML network, would be used as justification to cut spending rather than improve the network.

Mitchell Smith

Queensland surgeons won't be distracted by Twitter if Queensland Health has anything to do with it.

One of Queensland Health's most senior officials would be very concerned about the risk to patients if Australian doctors followed the lead of their US counterparts by live-tweeting medical procedures.

Deputy director-general Michael Cleary said he was "not aware of any instances in Australia of staff live tweeting or using social media" during surgical or other procedures.

"But I would find this type of behaviour very concerning given the potential risk to patient safety," Dr Cleary said.

This comes after a number of reports of US surgeons and patients using social media to broadcast live operations.

Anyone who has been tracking health policy debate at a national level over the past three years could be forgiven for expecting a bit more of their politicians during this 2013 federal election campaign.

In March 2010, before he was axed as Prime Minister, Kevin Rudd outlined the most ambitious reform to hospitals and hospital funding Australia had seen since federation. His successor, Julia Gillard, a few months later took to the election an ambitious $277 million program for mental health with no lesser aim than stopping ­suicide across the nation.

In 2013 there are no big visions or competing plans for reform. There are worthy funding announcements of a hundred million or so here or there, but rather than conducting a policy argument, Labor and the Coalition have traded blows over who might have the most budget cuts up their sleeves.

The conclusion one might draw from this is that both sides have decided the status quo is not that bad. Both health minister Tanya Plibersek and her opposition counterpart, Peter Dutton, get close to agreeing on that point in separate interviews with The ­Australian Financial Review.

Former REA Group executive Andy Sheats wants to shake up the $16 billion private health insurance sector, the way realestate.com.au transformed buying and selling houses.

The last new substantial health insurance company to open its doors was Medibank Private in 1997, according Mr Sheats. Even though the industry has moved online, he feels there is room for a new, more modern player.

Launched in April 2012, his online health insurance company, health.com.au, generated sales of $45 million in its first year and employs 23 people. It has already grown to have more than 40,000 members.

“Health insurance is a massive industry and there is plenty of room for everybody,” Mr Sheats said.

After six years as Opposition health spokesman, Peter Dutton tells MO why he’s ready to step out into the spotlight.

As his website boasts, Peter Dutton was a retired policeman of almost a decade’s service and a former business owner by the time he entered federal parliament in 2001 at the age of 30.

In order to do so he rolled Democrat defector Cheryl Kernot in the outer-northern Brisbane suburbs seat of Dickson and quickly rose to a ministry position during his mentor John Howard’s final term as prime minister.

His Wikipedia page suggests that as a rising star within the Liberal movement, he is seen by some as a future party leader and last week he accused Health Minister Tanya Plibersek of having a “barely veiled contempt for doctors”.

Australia’s biggest active electronic health record system has been quietly operating for nearly a decade – and now covers 200,000 patient records in 12 different public hospitals and 14 area health services in around 114 sites across South West Victoria.

The South West Alliance of Rural Health (SWARH), http://www.swarh2.com.au was formed in 1997 to deliver IT services for all public acute hospitals and associated health services in the region extending from west of Melbourne to the South Australian border – some 60,000 square kilometres, and now connects all sites across a secure broadband network.

“We started setting up the groundwork for a shared health record database in 2000, and we had completed all the agreements in 2003 so 12 different organisations used a unique ID to track patients between the different sites,” says Garry Druitt, who is CIO at SWARH.

FUNDING for research body National ICT Australia has been slashed as part of Coalition cuts before the federal election.

The Fiscal Budget Impact of Federal Coalition Policies released by opposition treasury spokesman Joe Hockey includes $42 million cuts by 2015-16 for discontinuing direct federal government funding to the ICT Centre of Excellence.

Given that NICTA bagged $185.50 from the Federal Government for 2011-15 at an average of $46.4 million per year, the cut is equivalent to an entire year's federal funding of the ICT research icon.

NICTA had obtained the funds just last month, which means it would have been funded for the 2015-16 financial year; the cut raises the question of whether the Coalition will offer NICTA financial support beyond June 2015, and if not, whether NICTA's days are numbered.

Parliamentary Sketch Writer for the Sydney Morning Herald

Karl the medical simulation dummy grimaced in what appeared to be existential, if not physical, pain.

Karl was simulating acute respiratory distress for the benefit of nursing students at the University of Tasmania. The students were simulating a training exercise for the benefit of Prime Minister Kevin Rudd, who observed them through one-sided glass. A mob of cameras, journalists and curious campus onlookers observed him.

Such are the simulated scenes of the election campaign, which on Tuesday brought the prime ministerial posse to the university nursing centre in Launceston.

In a press conference in a room stuffed with fake body parts, Mr Rudd promised $28 million for a "health hub" research and training facility. It would create hundreds of jobs, he said, and jobs are sorely needed in the economically depressed southern-most state.

A SIMPLE alarm on an asthma inhaler could help thousands of Australians better manage the condition -- and, more broadly, demonstrate the huge potential of such technologies.

While the future of telehealth has long been promoted, researcher Juliet Foster from the Woolcock Institute of Medical Research yesterday envisaged a "utopia" where linked-in devices and electronic medical records help keep people out of hospital and an early grave.

In a paper published in the latest Journal of Allergy and Clinical Immunology (In Practice), Dr Foster demonstrated how electronic monitoring devices for preventive inhalers could improve adherence rates when used to either alert asthmatics to a missed dose or provide trend data to a doctor.

"Devices like this are seen as quite expensive and difficult to implement in healthcare systems but I think that will change when things like electronic health records become the norm," she said.

“My point in telling this story is not to demonstrate how I beat the EEOB’s security — I’m sure the badge was quickly deactivated and showed up in some missing-badge log next to my name — but to illustrate how security vulnerabilities can result from human/machine trust failures. Something went wrong between when I went through the gate and when the person after me did. The system knew it but couldn’t adequately explain it to the guards. The guards knew it but didn’t know the details. Because the failure occurred when the person after me tried to leave the building, they assumed she was the problem. And when they cleared her of wrongdoing, they blamed the system.”

THE Coalition, if elected, will open up an online window viewable by the public that tracks how major federal IT projects are performing and shake up oversight of government technology spending.

The proposed online dashboard window was one of a list of digital economy and e-government initiatives released yesterday in a joint statement by the Coalition's finance and communications spokesmen Andrew Robb and Malcolm Turnbull.

As well as the dashboard, the Coalition promised to trial an opt-in, secure digital inbox for communications from all levels of government to citizens, from next year and to require three government agencies from next year to trial cheap, new-wave telepresence systems such as browser-based Web Real-Time Communications.

The dashboard idea has been copied from the Obama administration in the US, which has had its www.itdashboard.gov service online since 2009.

THE company building Labor's $37.4 billion National Broadband Network could be forced to repair tens of thousands of faulty connections after cutting corners in the construction processes to boost the number of homes passed by the massive infrastructure project.

The Australian can reveal that as of last week, connections to as many as 21,000 - one in eight - of the 163,500 existing homes and businesses passed by the fibre network were considered to contain defects in the network construction. Up to 7000 have major defects, which according to NBN Co documents, are those at risk of service degradation, outages or health and safety hazards.

The defects mean that network connections to thousands of homes and businesses, which have been classified as "ready for service", may require repairs before users can access the internet on the new network.

NBN Co last night disputed the figures, admitting there were significant defects but insisting the total number was lower than the figures obtained by The Australian.

If there is ever a textbook case of "mistaking activity for action" then this surely is a prime example that takes the cake…

Who really and truly cares about Registrations? It's a complete meaningless, fruitless measure of no significance whatsoever with respect to the PCEHR and its Value or Return on Investment for Healthcare.

Sure, why not measure Australia’s GNP by the amount of new Registrations on the Births, Deaths and Marriages registries? As absurd as this is, it’s tantamount to what NEHTA is Self-Promoting on its “SCORECARD”!

NEHTA's naiveté and ignorance in publishing this utter rubbish is unfathomable.

A very serious concern and telling indicator of the incompetence on display here, wasting vast amounts of Taxpayers’ money is the indication:

Health Outcome Realised"[To Be Determined]"

If NEHTA doesn't already have clearly DEFINED what the Targeted "Health Outcomes" are and what level of MEASURED "Health Outcomes" have been achieved to date, then they should never have been given a single dollar of Taxpayers' money to waste in this disgraceful manner in the first place.

NEHTA must have a self-harm or self-destruct organisational streak if they thought anything positive for them would result from publishing this unbelievably meaningless self-promoting Garbage.

Shame on Swan, Roxon, Plibersek, Halton, Fleming and the NEHTA Board for this unconscionable waste of Taxpayers’ funds spent on the PCEHR and its associated futile initiatives…

A future Auditor-General inquiry into this Healthcare debacle needs to clearly illustrate the “Opportunity Cost” this bureaucratic/technocratic wet-dream has been by the quantity and magnitude of TRUE “Front Line Services” forsaken and unable to be funded by the Taxpayers’ funds redirected and wasted on this easily avoidable and very regrettable eHealth pipedream!